The government’s Economic Development Policy (EDP) 2017 says selective services in the health sector will be opened to private practices with the government regulating quality of health services and human resources.
However, the health ministry says it cannot allow private practices unhesitatingly because they need to look at financial incentives and their Technical Team along with the Ministry of Economic Affairs, will study and examine whether private practice should be allowed in the health sector.
“If private practices would favor only a small chunk of the population say around only 10 per cent, then we might not agree because our responsibility is to ensure that any scheme or guideline that we draw on should not only favor a small chunk of the population but all the people of a country and that is where equity comes in,” the health minister Tandin Wangchuk said.
“The National Health Policy 2011 says private sector and foreign direct investments shall be allowed to provide high end and specialized medical diagnostic and treatment services in compliance with National Standards and Law,” said the Health Minister. “Private practices should be encouraged but at the right time when all the people in a country are financially proficient to pay for the services. I believe only 10 per cent of the population can pay for the private services right now.”
He added, “I agree that with the starting of medical private practices in a country would reduce the burden of the government and also provide more desirable and valuable medical services to the people but on the contrary there are so many negative effects on people.”
The minister said that though starting a medical private practice is viewed as a financially rewarding accomplishment, it is also a challenging endeavor. He pointed out that starting a medical private practice is similar to launching any other small business. Roughly 50 per cent of new business folds within 5 years. “So there are many things we need to consider before we start a private practice,” the health minister said.
“In Thimphu there are two private diagnosis centers and much as we feel like these private centers are unhealthy in our country right now we cannot reverse it because it is already there, they have invested a huge amount of money in it and there are people availing such services,” the minister said.
Ugen Dophu, Secretary of the Ministry of Health, said, “We are blessed that the government of Bhutan is providing us free medical services where we don’t even have to pay a cent. The Royal Government is providing free health care through the public hospital network both in modern and traditional medical system. The government is also trying to provide high-end luxury medical facilities in the country. The participation of the private sector or foreign companies and individual in the health sector shall not under any circumstances lead to privatization of the existing public health services”.
He also said that given the critical shortage of health personnel in the country, the government is trying to bring expatriate health and medical personnel from other countries to provide better services to the people.
He said if medical private practice is allowed in a country, most of the medical personnel would leave the public hospitals for private medical centers because private centers would obviously provide higher wages to the medical personnel. Also nurses and other medical staffs would leave the public hospital and move to private centers. So the government hospital would face a shortage of medical personnel and eventually it would affect the low income people who can’t avail private centers.
There is also a class of people who claims that the government should allow private practice in the health sector. “Those people are the ones who are willing to pay a certain amount of money from their pocket because they do not want to stand in a long queue,” Ugen Dophu said.
“The Last time I went to Jigme Dorji Wangchuk National Referral Hospital (JDWNRH) Thimphu for Ultrasound I had to wait for more than 4 hours just to do the ultrasound,” Pema Choden, a patient in the waiting room, said. “So I went to a private Diagnosis Center where I promptly did my ultrasound paying Nu 1500 which is quite reasonable.”
Pema Choden, who is impressed with the doctor, staff and the services they provided, said, “Thanks to Doctor Ballabh, now we have an option, we don’t have to go to Thimphu hospital and wait in a long queue,” she said.
Doctor Ballabh Sharma from the Pedkar Diagnosis Center said, “The diagnosis center started 2 years ago with a prime objective to provide timely and quality diagnostic services to the people”.
The Health minister reflecting the mood in the ministry said, “Our fear is that the health sector being opened to private investment and practices could lead to privatization of the public health services. So we have decided to allow only selective services in health sector and if it was me alone to decide whether to allow private practices, I would never say yes to private practice.”